title: Burden of tuberculosis in indigenous peoples globally: a systematic review.
abstract: BACKGROUND
  The burden of tuberculosis (TB) in the estimated 370 million indigenous peoples worldwide is unknown.
  
  
  OBJECTIVE
  To conduct a literature review to summarize the TB burden in indigenous peoples, identify gaps in current knowledge, and provide the foundation for a research agenda prioritizing indigenous health within TB control.
  
  
  METHODS
  A systematic literature review identified articles published between January 1990 and November 2011 quantifying TB disease burden in indigenous populations worldwide.
  
  
  RESULTS
  Among the 91 articles from 19 countries included in the review, only 56 were from outside Australia, Canada, New Zealand and the United States. The majority of the studies showed higher TB rates among indigenous groups than non-indigenous groups. Studies from the Amazon generally reported the highest TB prevalence and incidence, but select populations from South-East Asia and Africa were found to have similarly high rates of TB. In North America, the Inuit had the highest reported TB incidence (156/100000), whereas the Metis of Canada and American Indians/Alaska Natives experienced rates of <10/100000. New Zealand's Maori and Pacific Islanders had higher TB incidence rates than Australian Aborigines, but all were at greater risk of developing TB than non-indigenous groups.
  
  
  CONCLUSIONS
  Where data exist, indigenous peoples were generally found to have higher rates of TB disease than non-indigenous peoples; however, this burden varied greatly. The paucity of published information on TB burden among indigenous peoples highlights the need to implement and improve TB surveillance to better measure and understand global disparities in TB rates.
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors.forename: D
authors.initials: D
authors.lastname: Tollefson
authors.forename: E
authors.initials: E
authors.lastname: Bloss
authors.forename: A
authors.initials: A
authors.lastname: Fanning
authors.forename: J T
authors.initials: JT
authors.lastname: Redd
authors.forename: K
authors.initials: K
authors.lastname: Barker
authors.forename: E
authors.initials: E
authors.lastname: McCray
mesh_terms: D003140:Communicable Disease Control / Q000379:methods; D005006:Ethnicity / Q000706:statistics & numerical data*; D014943:Global Health; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D008403:Mass Screening; D015995:Prevalence; D011379:Prognosis; D044469:Racial Groups / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D014376:Tuberculosis / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control